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No SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: Ripon Cogeneration Page 2 of 2 Facility Address: City: Inspection Date: 944 S. Stockton Ave. Ripon Sep 3, 2013 FA #: PR #: Program Element: 10760 2831 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum >_1,320 gallons in tanks* and containers**. Complete one box for each tank or each cumulative container product type. #of Containers: 20 TA#: oZO ❑ Tank (2820) ❑X Containers (2821) 1 1, 100 Product Type: oils - new & used (55 gal) Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: #of Containers: 2 TA#:��_ ❑ Tank (2820) ❑X Containers (2821) 2Total Product Type: used oil (55 gal.) 110 Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Product Type: - Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 1,210 gallons Total Capacity for Site: L}� gallons Comments: Per the SPCC Plan on site EHD Inspector: X�- I Reviewed Date: By Initial: C11 0? Entered Date: By Initial: U *Abov rou d storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. **Container means a storage device designed to be moved when full. EHD 28-01 REV 04/19/12 AST SURVEY FORM